In hunting and gathering cultures, alternating movement patterns was part of living and essential for health. This shift from dynamic movement to static or awkward positions is illustrated in Figure 1.
Figure 1. The shift from dynamic movement to immobility and near vision as illustrated by the Hadzabe men in Tanzania returning from a hunt to our modern immobilized work and pleasure positions (Reproduced by permission from Peper, Harvey & Faass, 2020).
Dynamic movement promotes blood and lymph circulation and reduces static pressures. At present times our work and leisure activities increase immobility and static positions as we predominantly have shifted to a sitting immobilized position. This significantly increases musculoskeletal discomfort, cardiovascular disease, diabetes etc. The importance of movement as a factor to enhance health is illustrated in the recent findings of 2110 middle aged participants who were followed up for ten years. Those who took approximately 7000 steps per day or more experienced significantly lower mortality rates compared with participants taking fewer than 7000 steps per day (Paluch et al., 2021). Just having the head forward while looking at the cellphone significantly increases the forces on the muscles holding the head up as illustrated in Figure 2.
Figure 2. The head-forward position puts as much as sixty pounds of pressure on the neck muscles and spine (reproduced by permission from Dr. Kenneth Hansaraj, 2014).
For background and recommendations on what how to reduce static positions, look at our book, TechStress-How technology is hijacking our lives, strategies for coping and pragmatic ergonomics. and the superb article, Static postures are harmful – dynamic postures at work are key to musculoskeletal health, published by the European Agency for Safety and Health at Work (EU-OSHA, Sept 16, 2021) and reproduced below.
Our bodies are built for movement – it’s a central part of maintaining a healthy musculoskeletal system and the less we move, the more chance we have of developing health issues including musculoskeletal disorders (MSDs), type 2 diabetes, cardiovascular disease, cancer and more. However, the negative effects of sedentary work can be mitigated by paying attention to the postures we adopt when we work.
Whether workers are standing or seated while working, maintaining a good ergonomic posture is essential when it comes to preventing MSDs. Poor or awkward postures put unnecessary strain on the musculoskeletal system and, over time, can cause the deterioration of muscle fibres and joints.
Poor or awkward postures include those which involve parts of the body not being in their natural position. More muscular effort is needed to maintain unnatural postures, which increases the energy used by the body and can cause fatigue, discomfort and pain. Unnatural postures also put strain on tendons, ligaments and nerves, which increases the risk of injury. For example, the risk of neck pain increases when the neck is rotated more than 45 degrees for more than 25% of the working day.
These postures, including slouching, rotation of the forearms, or prolonged periods of sitting or standing in the same spot, can cause pain in the lower back and upper limbs. The risk increases when combined with repetitive work, static muscle load, or the need to apply force or reach. And even natural or good postures maintained for any length of time become uncomfortable and eventually painful. Everyone has experienced stiffness after being in the same position for any length of time.
What do we mean by ‘good posture’?
For workers, especially those in sedentary jobs such as office work, factory work or driving, it is important to recognise and adopt good postures. A good posture should be comfortable and allow the joints to be naturally aligned. The segments of our body can be divided into three cross-sectional anatomical planes: the sagittal plane, which concerns bending forwards and backwards; the frontal plane, which concerns bending sideways; and finally the transverse plane, which refers to rotation or twisting of the body parts. A good posture is one that ensures that all three of these planes are set at neutral positions as much as possible, in that the worker is not leaning backwards, forwards or to any particular side, and their limbs and torso are not rotated or twisted. Adopting neutral postures will help to lessen the strain on the worker’s muscles, tendons and skeletal system, and reduces the risk of them causing or aggravating an MSD.
In practice, workers can consider the following checklist to ensure that they’re standing or sitting in a neutral position:
- Keep the neck vertical and the back in an upright position.
- Ensure the elbows are below the chest and avoid having to reach excessively.
- Keep the shoulders relaxed and use back and arm rests where possible and ensure that they are adjusted to the size and shape of the worker.
- Avoid rotating the forearms or excessively moving the wrists.
- Ensure that any work tools can be held comfortably, and that clothing doesn’t restrain or prevent movement.
- Allow room to comfortably move the legs and feet and avoid frequent kneeling or squatting.
- Ensure that long periods of standing or sitting in the same posture can be broken up.
Employers can assist workers in adopting good postures by communicating checklists such as this one, and by promoting physical activity where possible, encouraging the fair rotation of tasks between employees to avoid them consistently making repetitive movements, and ensuring that workers have the capacity to take regular breaks.
Why our next posture is the best posture
However, maintaining a good posture at all times is not enough to reduce the risk of MSDs, and can even be harmful. Static postures, even if ergonomic, are still a risk factor if over-used. Our body requires movement and variety, which is why the best approach is to use a variety of ergonomic postures in rotation, breaking up long periods of static working with stretching, exercise, and movement. This is known as adopting ‘dynamic positions’.
It is important not only for workers who spend much of their day seated, but also for workers who primarily stand – such as factory workers in assembly lines. In both cases, sitting and standing are not opposites. The opposite of both is movement. Changing postures between sitting and standing is not sufficient for any worker – the working environment must still offer ways of varying their postures and incorporating movement into their daily working routines. What’s more, if standing work cannot be avoided, workers do not need lots of space in order to adopt dynamic positions in a healthy way. Blood flow propulsion mechanisms can still work correctly even if the worker is only moving around in one square metre. However it is still the case that they should have a break after 30 minutes of standing.
Work should therefore not only facilitate good postures, but ensure that good, ergonomic postures are also dynamic. Switching between sitting, standing and moving while ensuring that the musculoskeletal frame is not under any unnecessary tension can help sedentary workers avoid the onset of MSDs and other health problems. For more information visit the priority area on sedentary work.
EU-OSHA. (September 16, 2021). Static postures are harmful – dynamic postures at work are key to musculoskeletal health. https://healthy-workplaces.eu/en/media-centre/news/static-postures-are-harmful-dynamic-postures-work-are-key-musculoskeletal-health?
Hansraj, K. K. (2014). Assessment of Stresses in the Cervical Spine Caused by Posture and Position of the Head. Surgical Technology International, 25, 277–79. https://pubmed.ncbi.nlm.nih.gov/25393825/
Paluch, A.E., Gabriel, K.P., Fulton, J.E., et al.(2021). Steps per Day and All-Cause Mortality in Middle-aged Adults in the Coronary Artery Risk Development in Young Adults Study. JAMA Netw Open, 4(9):e2124516. https://doi.org/10.1001/jamanetworkopen.2021.24516
Peper, E., Harvey, R. & Faass, N. (2020). TechStress-How Technology is Hijacking our Lives, Strategies for Coping and Pragmatic Ergonomics. Berkeley: North Atlantic books. https://www.penguinrandomhouse.com/books/232119/tech-stress-by-erik-peper-phd/
Erik Peper and Meir Schneider
As a young child I laid on the couch and I read one book after the other. Hours would pass as I was drawn into the stories. By the age of 12 I was so nearsighted that I had to wear glasses. When my son started to learn to read, I asked him to look away at the far distance after reading a page. Even today at age 34, he continues this habit of looking away for a moment at the distance after reading or writing a page. He is a voracious reader and a novelist of speculative fiction. His vision is perfect. –Erik Peper
How come people in preliterate, hunting and gatherer, and agricultural societies tend to have better vision and very low rates of nearsightedness (Cordain et al, 2003)? The same appear true for people today who spent much of their childhood outdoors as compared to those who predominantly stay indoors. On the other hand, how come 85% of teenagers in Singapore are myopic (neasighted) and how come in the United States myopia rate have increased for children from 25% in the 1970s to 42% in 2000s (Bressler, 2020; Min, 2019)?
Why should you worry that your child may become nearsighted since it is easy correct with contacts or glasses? Sadly, in numerous cases, children with compromised vision and who have difficulty reading the blackboard may be labeled disruptive or having learning disability. The vision problems can only be corrected if the parents are aware of the vision problem (see https://www.covd.org/page/symptoms for symptoms that may be related to vision problems). In addition, glasses may be stigmatizing and children may not want to wear glasses because of vanity or the fear of being bullied.
The recent epidemic of near sightedness is paritally a result of disrespecting our evolutionary survival patterns that allowed us to survive and thrive. Throughout human history, people continuously alternated by looking nearby and at the distance. When looking up close, the extraocular muscles contract to converge the eyes and the ciliary muscles around the lens contract to increase the curvature of the lens so that the scene is in focus on the retina — this muscle tension creates near visual stress.
The shift from alternating between far and near vision to predominantly near vision and immobility
Figure 2. The traditional culture of Hdzabe men in Tanzania returning from a hunt. Notice how upright they walk and look at the far distance as compared to young people today who slouch and look predominantly at nearby screens.
Experience the effect of near visual stress.
Bring your arm in front of you and point your thumb up. Look at your thumb on the stretched out arm. Keep focusing on the thumb and slow bring the thumb four inches from your nose. Keep focusing on the thumb for a half minute. Drop the arm to the side, and look outside at the far distance.
What did you experience? Almost everyone reports feeling tension in the eyes and a sense of pressure inside around and behind their eyes. When looking at the distance, the tension slowly dissipates. For some the tension is released immediately while for others it may take many minutes before the tension disappears especially if one is older. Many adults experience that after working at the computer, their distant vision is more fuzzy and that it takes a while to return to normal clarity.
When the eyes focus at the distance, the ciliary muscles around lens relaxes so that the lens can flatten and the extra ocular muscles relax so that the eyes can diverge and objects in the distance are in focus. Healthy vision is the alternation between near and far focus– an automatic process by which the muscles of the eyes tightening and relax/regenerate.
Use develops structure and structure limits use
If we predominantly look at nearby surfaces, we increase near visual stress and the risk of developing myopia. As children grow, the use of their eyes will change the shape of the eyeball so that the muscles will have to contract less to keep the visual object into focus. If the eyes predominantly look at near objects, books, cellphones, tablets, toys, and walls in a room where there is little opportunity to look at the far distance, the eye ball will elongate and the child will more likely become near sighted. Over the last thirty year and escalated during COVID’s reside-in-place policies, children spent more and more time indoors while looking at screens and nearby walls in their rooms. Predominantly focusing on nearby objects starts even earlier as parents provide screens to baby and toddlers to distract and entertain them. The constant near vision remodels the shape of eye and the child will likely develop near sightedness.
Health risks of sightedness and focusing predominantly upon nearby objects
- Increased risk of get into an accident as we have reduced peripheral vision. In earlier times if you were walking in jungle, you would not survive without being aware of your peripheral vision. Any small visual change could indicate the possible presence food or predator, friend or foe. Now we focus predominantly centrally and are less aware of our periphery. Observe how your peripheral awareness decreases when you bring your nose to the screen to see more clearly. When outside and focusing close up the risk of accidents (tripping, being hit by cars, bumping into people and objects) significantly increases as shown in figure 3 and illustrated in the video clip.
Pedestrian accidents (head forward with loss of peripheral vision)
- Myopia increases the risk of eye disorder. The risk for glaucoma, one the leading causes of blindness, is doubled (Susanna, De Moraes, Cioffi, & Ritch, R. 2015). The excessive tension around the eyes and ciliary muscles around the lens can interfere with the outflow of the excess fluids of the aqueous humour through the schlemm canal and may compromise the production of the aqueous humour fluid. These canals are complex vascular structures that maintains fluid pressure balance within the anterior segment of the eye. When the normal outflow is hindered it would contribute to elevated intraocular pressure and create high tension glaucoma (Andrés-Guerrero, García-Feijoo, & Konstas, 2017). Myopia also increases the risk for retinal detachment and tears, macular degeneration and cataract. (Williams & Hammond, 2019).
By learning to relax the muscles around the lens, eye and face and sensing a feeling of soft eyes, the restriction around the schlemm canals is reduced and the fluids can drain out easier and is one possible approach to reverse glaucoma (Dada et al., 2018; Peper, Pelletier & Tandy, 1979).
- Increase in neck and upper back compression when the person cranes their head forward or looks down while reading books/articles, looking at a cellphone or a laptop screen, This often results in an increase of back, neck and shoulder pain as well as headaches (Harvey, Peper, Booiman, Heredia Cedillo, & Villagomez, 2018; Hansraj, 2014).
- Decrease in subjective energy and increase in helpless, hopeless, powerless and defeated thoughts when the person habitually looks down in a slouched position (Peper, Booiman, Lin, & Harvey, 2016; Peper, Lin, Harvey, & Perez, 2017).
WHAT CAN YOU DO?
The solutions are remarkable simple. Respect your evolutionary background and allow your eyes to spontaneously alternate between looking at near and far objects while being upright (Schneider, 2016; Peper, 2021; Peper, Harvey & Faass, 2020).
For yourself and your child
- Let children play outside so that they automatically look far and near.
- When teaching children to read have them look at the distance at the end of every paragraph or page to relax the eyes.
- Limit screen time and alternate with outdoor activities
- Every 15 to 20 minutes take a vision break when reading or watching screens. Get up, wiggle around, move your neck and shoulders, and look out the window at the far distance.
- When looking at digital screens, look away every few minutes. As you look away, close your eyes for a moment and as you are exhaling gently open your eyes.
- Practice palming and relaxing the eyes. For detailed guidance and instruction see the YouTube video by Meir Schneider.
Create healthy eye programs in schools and work
- Arrange 30 minute lesson plans and in between each lesson plan take a vision and movement breaks. Have children get up from their desks and move around. If possible have them look out the window or go outside and describe the furthest object they can see such as the shape of clouds, roof line or details of the top of trees.
- Teach young children as they are learning reading and math to look away at the distance after reading a paragraph or finishing a math problem.
- Teach palming for children.
- During recess have students play games that integrate coordination with vision such as ball games.
- Episodically, have students close their eyes, breathe diaphragmatically and then as they exhale slowly open their eyes and look for a moment at the world with sleepy/dreamy eyes.
- Whenever using screen use every opportunity to look away at the distance and for a moment close your eyes and relax your neck and shoulders.
BOOKS TO OPTIMIZE VISION AND TRANSFORM TECHSTRESS INTO TECHHEALTH
YOUTUBE PRESENTATION, Transforming Tech Stress into Tech Health.
ADDITIONAL BLOGS THAT FOCUS ON RESOLVING EYES STREAN AND TECHSTRESS
Cordain, L., Eaton, S.B., Miller, J. B., Lindeberg, S., & Jensen, C. (2003). An evolutionary analysis of the aetiology and pathogenesis of juvenile‐onset myopia. Acta Ophthalmologica Scandinavica, 80(2), 125-135.
Dada, T., Mittal, D., Mohanty, K., Faiq, M.A., Bhat, M.A., Yadav, R.K., Sihota, R., Sidhu, T,, Velpandian, T., Kalaivani, M., Pandey, R.M., Gao, Y., Sabel, B,A., & Dada, R. (2018). Mindfulness Meditation Reduces Intraocular Pressure, Lowers Stress Biomarkers and Modulates Gene Expression in Glaucoma: A Randomized Controlled Trial. J Glaucoma, 27(12), 1061-1067.
Harvey, R., Peper, E., Booiman, A., Heredia Cedillo, A., & Villagomez, E. (2018). The effect of head and neck position on head rotation, cervical muscle tension and symptoms. Biofeedback. 46(3), 65–71.
Adapted from: Peper, E., Wilson, V., Martin, M., Rosegard, E., & Harvey, R. (2021). Avoid Zoom fatigue, be present and learn. NeuroRegulation, 8(1), 47–56. https://doi.org/10.15540/nr.8.1.47
After a while, it all seems the same. Sitting and looking at the screen while working, taking classes, entertaining, streaming videos and socializing. The longer I sit and watch screens, the more I tend to feel drained and passive, and the more challenging it is to be present, productive and pay attention.
Overnight, the pandemic transformed college teaching from in-person to online education. Zoom became the preferred academic teaching and learning platform for synchronous education. Students and faculty now sat and looked at the screen for hours. While looking at the screen, the viewers were often distracted by events in their environment, notifications from smartphones, social media and email, which promoted multitasking (Solis, 2019). The digital distractions causing people to respond to twice as many devices with half of our attention—a process labeled ‘semi-tasking’- meaning getting twice as much done half as well.
For many students synchronous online learning was more challenging, especially after teaching was shifted to a Zoom environment without adapting the course materials to optimize online learning. During polling of 325 undergraduate university students at a metropolitan university who were all taking synchronous online Zoom classes, the vast majority reported that learning was somewhat to extremely difficult, with only the minority of students (approximately 6%) preferring online learning as shown in Figure 1.
Figure 1. Survey of 325 Undergraduates comparing Zoom online learning compared to the previous in person classes. Approximately 94% had moderate to considerable difficulty with on line learning.
The increased self-report on difficulty experienced in synchronous Zoom online learning may also affect academic achievement. At the same time, many people have reported an increase in physical, behavioral and psycho-emotional problems (e.g. backache, headache, stomachache, eye-strain, sore neck and shoulder pain, over or under eating, over or under sleeping, over or under exercising, ruminative thoughts related to categories of anxiety/fear, boredom/numbness, depression/sadness, anger/hostility, etc) (Fosslien & Duffy, 2020; Lee, 2020; Intolo, 2019; Leeb et al, 2020; McGinty et al, 2020; Peper & Harvey, 2018; Peper, Harvey and Faas, 2020).
This post explores factors that contribute to zoom fatigue and offers practical suggestions to optimize learning during synchronous Zoom online education. The concepts are derived from our teaching athletes to sustain peak mental and physical performance, with the implication that the same concepts can help students towards sustaining on-topic attention during online learning (Wilson & Peper, 2011). In sports, the coach can help guide the athlete; however, the athlete needs to be present and motivated. Faculty have a responsibility to support, encourage, and engage students while students have the responsibility to configure themselves into an optimum learning state.
Part 1: Factors that contribute to Zoom fatigue
Differences in communication between live and computer communication
Until the 20th century, almost all communication included non-verbal expressions. The speaker used verbal and nonverbal expressions while the respondent would immediately show a reaction to the speaker. There was a continuous dynamic verbal and nonverbal exchange. The listener would respond to the speaker. If they agreed they nodded their head. If they disagreed or were intimidated they would provide alternative body movements (e.g., shake their head) or facial expressions (look away or frown). During normal conversations, both the speaker’s facial expression and body language are noticed and responded to, which are in turn, can be used as feedback by the other person. In large group sessions with many participants, the visual feedback is reduced and facial responses are difficult to distinguish especially the gallery view.
In a Zoom environment, both the sender and receiver are watching the computer screen without awareness that nonverbal cues are essential for the purpose of understanding not only what is being said but also for the implied meaning and its importance. These non-verbal cues are usually processed without awareness in live person-to-person exchange. While sending and receiving are usually simultaneous, there can exist a disconnect between the attached meanings of the encoded information and that of the decoded information due to the inconsistent existence of important nonverbal components. In a Zoom environment, the end-result could mean multiple images of receivers providing the sender with little or no non-verbal cues with which to interpret the meaning they have attached to your message. The person may appear to look at you; however, you do not know whether they are attending to you, have a neurological disorder and cannot respond, are reading their emails, watching YouTube videos, or texting on their phone. Additionally, the nonverbal cues they are sending may not be related to your message but to their reaction to other media, people or distractions not seen by the presenter.
This mode of communication is different from communication patterns that evolved through natural selection and allowed the human species to thrive and survive. For the first time in human history we learn, teach, work, socialize, and entertain in front of the same screen. In many cases, communication in the era of smartphones has been reduced to texting, writing digital responses or reacting to media content on any screen. Over the past few decades, it is possible for people to communicate through more disembodied, off-topic and external modes of interaction. So many types of learning activities vie for our attention and can occur without leaving our chairs, thus, it may be difficult to stay on-topic online Zoom classes (Keller, Davidesco, & Tanner, 2020).
Normal communication typically involves whole body movements (face, head, arms and hands) which tends to energize or sometimes distract the speaker or listener (Kendon, 2004). When communicating with friends-we often move our bodies dynamically and responsively during the discussion. With synchronous large online lectures, students tend to be passive and just sit and watch. This state of sitting and just watching the screen is similar to watching video entertainment where we sit for a long time and are covertly conditioned not to act.
Unknowingly, we have trained ourselves not to initiate action since the screen does not provide feedback to our responses- a process so different from talking and responding spontaneously in groups of participants.
When communication is safe, people interact, respond and chime in. In large groups, just like large lectures, Zoom tends to inhibit this process because it delays social feedback since most people mute their microphone to avoid extraneous noise. This is usually the rule for large groups although for small groups, people often unmute themselves. The physical act of unmuting is an additional barrier to spontaneous verbal responses. This shift of attention induces a delay before responding. From a communication perspective, a delay before responding reduces the spontaneity and is may be interpreted more negatively by the listener (Roberts, Margutti, & Takano, 2011).
Facial Expressions and Auditory Processing
Facial expressions are a critical part of non- verbal feedback and signals to the other person that they are being listened to and provide cues that the interaction is safe. We unknowingly react to facial expressions–processed unconsciously through neuroception (Porges, 2017)–to indicate whether the person is signaling safety or danger. Usually when the person is facially responsive and shows expression, it signals safety and allows communication and intimacy to be developed. If the person shows no facial expressions (a still/flat face), we unconsciously interpret this as a signal of danger (Porges, 2017). The importance of responsive feedback is illustrated in the study by Tronick et al (1975) where mothers were instructed not to respond with facial and body cues to their infant. The babies rapidly became highly disturbed when the mother stayed nonresponsive as dramatically illustrated in the YouTube video, Still Face Experiment: Dr. Edward Tronick (Tronick, 2007). In adults lack of verbal and nonverbal feedback during social evaluations is extremely stressful (Gruenewald, Kemeny, Aziz, & Fahey, 2004; Birkett, 2011).
The absence of social facial and body feedback often makes teaching and learning more challenging. Namely, are the receivers–the invisible, (only their picture or name is shown), partially visible (facial features are indistinct due to backlighting) or ghosting (those whose picture and name are shown but are physically absent from the session)–understanding the information the way the sender intended?
Unlike traditional classroom settings where one has the benefit of seeing/sensing nonverbal cues, the Zoom gallery view often, the speaker may not know what how the audience is responding and this contributes to Zoom fatigue. In addition, the communication bond is often reduced when the speaker does not look at audience and the listener does not respond to the speaker with facial expressions. Zoom fatigue can also be reduced when online teaching tools are used appropriately by involving active feedback responses through polls, chat, etc. as well as asking specific participants to speak and give feedback.
What is unique to the synchronous online environment is that the speakers and participants view themselves. This is the first time in human history that people are seeing themselves while speaking. For some people, seeing themselves may increase anxiety and negative self-judgement- a process that is even more prevalent in teens. Some are self-conscious and some have social anxiety and do not want their face to be shown (Degges-White, 2020). In the past, most of us had no idea how we looked when others or ourselves are communicating—it is totally novel experience to see yourself while talking and communicating.
Reduced physical activity and increased near vision stress.
Before sheltering in place, I would walk from my house to the BART station, take the train to Daly City station and then walk to the university. At the university, I would climb stairs to go to my office, meet with other faculty and walk to the classroom. At the end of the day, I would walk back to the Bart station and eventually walk home. Without any thinking or trying to do any exercise, I usually would do 12,000 steps and about 25 stairs. Now, I am lucky if I do 3000 unless will myself to do more exercise. –Erik Peper
The move to a Zoom environment and sheltering in place meant that we sit more and more which tends to increase mortality, decrease subjective energy and contributes to an attitude of passive engagement, more as an observer than as a participant (Stamtakis et al, 2019; Patel et al, 2018; Oswald et. al., 2020; Yalçin, Özkurt, Özmaden & Yagmur, 2020). While sitting, we also tend to slouch as we look at the screen that may be a covert factor in the increasing rates of depression and anxiety.
This slouching position tends to decrease access to positive memories and allow easier access to negative memories (Peper et al, 2017) as well as interfere with academic performance. Peper et al (2018) found that students have more difficulty performing mental math in the slouched as compared to upright sitting position. To reduce the impact of sitting, Peper & Lin (2012) found that when student perform some physical activities (e.g., skipping in place) for just a minute they report a significantly increase subjective energy and attention levels.
When looking at the screen our eyes only focus on the screen, which is different from in-person communication where you look at the person and then look at behind or to the side of the person. Only looking at the screen means that to focus on the screen the muscles of the eyes tighten so that the eyes can converge and the ciliary muscles around the lens contract so that the lens curvature is increased which results in near visual stress. This continuous looking at a near object is different from normal eye function in which we alternately focus on nearby objects and then look far away which allows the muscles of the eyes to relax.
Numerous students reported that it was much easier to be distracted and multitask, check Instagram, facebook, TikTok, or respond to emails and texts than during face-to-face classroom sessions as illustrated by two students’ comments.
“Now that we are forced to stay at home, it’s hard to find time by myself, for myself, time to study, and or time to get away. It’s easy to get distracted and go a bit stir-crazy.”
“I find that online learning is more difficult for me because it’s harder for me to stay concentrated all day just looking at the screen.”
Students often reported that they had more difficulty remembering the materials presented during synchronous presentations. Most likely, the passivity while watching Zoom presentation affected the encoding and consolidation of new material into retrievable long term memory. The presented material was rapidly forgotten when the next screen image or advertisement appeared and competed with the course instructor for the student’s attention. We hypothesize that the many hours of watching TV and streaming videos have conditioned people to sit and take in information passively, while discouraging them to respond or initiate action (Mander, 1978; Mărchidan, 2019). Learning requires engagement, which means a shifting from passively watching and listening to being an active, participant shareholder in synchronous online classes. However, in most cases, students have not received information/education or training on HOW TO be a more active/engaged participant in a synchronous Zoom class.
Instructors also have many of the same issues when presenting classes online. They engage in multiple simultaneous roles: presenter, director, and producer. While teaching, they need to engage students, monitor the chat for feedback and look at the screen for facial responses. At the same time, they may face similar technical issues as those experienced by students such as internet connectivity, limited bandwidth, and mastering the technical features of synchronous online learning technology. At times, instructors feel that students expect each presentation to be as captivating as a TED talk. Thus, teaching has shifted from education to edutainment.
Part 2: Practical suggestions to optimize learning
To optimize learning in the synchronous online environment, teachers have the responsibility to reconfigure their teaching so that it incorporates active student involvement and students have the responsibility to be present and engaged. The following practices may facilitate learning:
Be present to learn
Mastering media presence is becoming even more important for everyone. The skill implemented in attending an online learning class will also be useful for professional development. Although the pandemic shifted personal interviews to online interviews, most likely, synchronous and asynchronous video interviews are part of the first automatic screening level to assess candidates for a job (Rubinstein, 2020).
Be visible for the other person looking at you to create a positive impression
Adjust your camera and lights so that your face is visible and you are looking at the person to whom you are talking. Your screen presence is representing you. Does the camera show you engaged or distracted lying on bed? Be aware that you and your background together create an impression. The concept that looking directly at the audience– looking directly at the camera–is not new. Everyone working in media (newscasters, politicians, actors) have been trained to make their faces visible and expressive. This means arranging your webcam at eye level right in front of you and speaking to the camera as if it is the person. Avoid looking down at the person on the screen since the viewer would see you looking look down and away. Be sure your face is illuminated and there are no bright light sources behind you (Purdy, 2020). We recommend that in small group, participants unmute their microphones so that people can respond spontaneously to each other unless there is excessive background noise.
Be a responsive and interactive listener to configure your brain to be engaged
Shift from being a passive absorber to an active participant even if your camera is off or the speaker cannot see you. Imagine being physically with the speaker and activate yourself by increasing your face and body animation as you are attending a synchronous online class. Thus, when you watch a presentation, act as if you are in a personal conversation with the presenter or the material. This means that if you agree, nod your head; if you disagree, shake your head (do this naturally without making it a work task). Do this for the whole session. Our research has shown that when college students purposely implement animated facial and body responses during Zoom classes, they report a significant increase in energy level, attention and involvement as compared to just attending normally in class (Peper & Yang, in press). See Figure 2.
Figure 2. Change in subjective energy, attention and involvement when the students significantly increase their facial and body animation by 123 % as compared to their normal non-expressive class behavior (Peper & Yang, 2021).
“I never realized how my expressions affected my attention. Class was much more fun”
-22 year old woman student.
“I can see how paying attention and participation play a large role in learning material. After trying to give positive facial and body feedback I felt more focused and I was taking better notes and felt I was understanding the material a bit better.”-28 year old medical student
Configure your body to attend and perform
Sit upright and adapt a position of empowerment. When we sit upright and expanded it is easier to have positive thoughts and detach from negative hopeless thoughts (Peper, Lin, Harvey, & Perez, 2017; Peper, Harvey, Mason, & Lin, 2018). Students also performed better in mental math when they sat upright as compared to collapsed. When students are provided ongoing feedback when they begin to slouch by an app that uses the computer camera to monitor slouching, they reported a significant decrease in neck and back symptoms (Chetwynd et al, 2020). As one of many students reported:
“Before when I didn’t use the app, I had a lots of shoulder and neck pain. Now when I use it, the pain went way down as I kept changing posture to the feedback signal. I had more energy and I was more alert. I did notice that when I would get the alert to sit up straight.”
Optimize concentration and learning
In the online environment, the structure more likely depends upon the person unlike the externally created structure of going to work or to class. Thus, purposely creating a time structure and scheduled time-periods to perform different tasks as time management skills are associated with improved school and work performance (Macan et al., 1990). Create an environment to promote concentration and reduce distractions.
- Stay on task and reduce interruption and practice refocusing on task. On the average we now check our phones 96 times a day—that is once every 10 minutes and an increase of 20% as compared to two years ago (Asurion Research, 2019). Those who do media multitasking such as texting while doing a task perform significantly worse on memory tasks than those who are not multitasking (Madore et al., 2020). Multitasking is negatively correlated with school performance (Giunchiglia et al, 2018). When working or attending a class or meeting, turn off all notifications (e.g., email, texts and social media). Then block out specific times when you work on Zoom and when you respond to email, phone or social media (Newport, 2016). Let people know that you will look at the notifications and respond in a predetermined time so that you will not be interrupted while working or studying. If you work where there are other people, arrange your workstation so that there are fewer distractions such as sitting with your back to other people. When students chose to implement a behavior change to monitor cellphone and media use and reduce the addictive behavior during a five-week self-healing project, many report a significant improvement of health and performance. One student observed that when she reduced her cellphone use her stress level equally decreased as shown in Fig 3.
Figure 3. Example of a student changing cellphone use and corresponding decrease in subjective stress level.
During this class project, many students observed that the continuous responding to notifications and social media affect their health and productivity. As one student reported,
The discovery of the time I wasted giving into distractions was increasing my anxiety, increasing my depression and making me feel completely inadequate. In the five-week period, I cut my cell phone usage by over half, from 32.5 hours to exactly 15 hours and used some of the time to do an early morning run in the park. Rediscovering this time makes me feel like my possibilities are endless. I can go to work full time, take online night courses reaching towards my goal of a higher degree, plus complete all my homework, take care of the house and chores, cook all my meals, and add reading a book for fun! –22 year old College Student
- Approached learning with a question. When you begin to study the material or attend a class, ask yourself questions that you would like to be answered. If possible, put your questions to the instructor. When you have a purpose, it is easier to stay emotionally present and remember the material (Osman, & Hannafin, 1994).
- Take written notes while attending a Zoom meeting or class. When participants take hand written notes versus on the computer they tend to integrate and remember the material much more than just watching passively (Mueller & Oppenheimer, 2014). Active note taking leads to focused attention and fewer distractions from social media content (Flanigan & Titsworth, 2020).
- Review materials. At the end of the class, meet with your fellow students on ZOOM or social media and review the class materials. As you discuss the materials, add comments to your notes and if possible, do a hierarchical outline to more easily remember the relationships among the ideas.
- Change your internal language. What we overtly or covertly say and believe is what we may become. When one says, “I am stupid”, “I can’t do math,” or “It is too difficult to learn,” one may become powerless which increases stress and inhibits cognitive function. Instead, change the internal language so that it implies that you can master the materials such as, “I need more time to study and to practice the material,” “Learning just takes time and at this moment it may take a bit longer than for someone else,” or “I need a better tutor.”
Create an environment to trigger the appropriate mental and emotional state for learning.
Learning and recall are state dependent. Without awareness, the learned content is covertly associated with environmental, emotional, social and kinesthetic cues. Thus, when you study in bed, the material is more easily accessed while lying down. When you study with music, the music becomes a retrieval cue. Without awareness, the materials are encoded with the cues of lying down or the music played in the background. When you take your exam in a different setting then you have studied, none of the covert cues are there, thus, it is more difficult to recall the material. Study and review the materials under similar conditions, as you will be tested.
To configure yourself to be ready to study, work, or socialize create different environments that are unique to each category of Zoom involvement (studying, working, socializing, entertaining). Pre COVID, we usually used different clothing for different events (work versus party) or different environments for different tasks (temple, churches, mosques, or synagogue for religious practice; bar or coffee shop to meet friends). Create a unique environment with each Zoom activity. The stimuli to be associated to the specific tasks can also include lighting, odors, sound or even drinks and food. These stimuli become the classically conditioned cues to evoke the appropriate response associated with the task just as Pavlov conditioned dogs to salivate by pairing a sound with the meat. Taking charge of the conditioning process may help many people to focus on their task as so many students use their bedroom, kitchen or living room for Zoom work which is not always conducive for learning or work.
- Wear task specific clothing just as you would have done going to work or school. When you plan to study, put on your study T-shirt. In time, the moment you put on the study T-shirt, you are cueing yourself to focus on studying. When finishing with studying, change your clothing.
- Arrange task specific backgrounds for each category of Zoom task. Place a different background such as a poster or wall hanging behind the computer screen-one for studying and another for entertainment. When finished with the specific Zoom event, take down the poster and change the background.
Optimize arousal and regenerate vision
- The longer we sit the more passive we tend to become. Teachers will benefit by interrupting the passive transfer of information by guiding students in fun short movements to increase arousal. If instructors fail to put in movement breaks, students sitting in front of screens can remind themselves to move. The challenge is that we are usually unaware of how much time has passed as we are captured by the screen. It is often helpful to use an app such as StretchBreak to remind yourself to get up and move.
- Get up and move every 30 minutes. After sitting for 30 minutes stretch, wiggle and move. Do the movements with vigor or even dance, look up and reach up. When you stand up and move your legs and feet, you tighten and relax your calf muscles that pump the venous blood and lymph fluids that have been pooling in your legs back to your heart. The calf muscle is often called the second heart because in facilitates venous blood return.
- Regenerate vision. Our eyes tend to get tired and world looks blurry. Interrupt the near vision stress by allowing the eyes to relax and regenerate.
- Palming. Bring your hands to your face and cup the hands so that there is no pressure on your eyeballs. Allow the base of the hands to touch the cheeks while the fingers are interlaced and resting your forehead. Then with your eyes closed imagine seeing black. Breathe slowly and diaphragmatically while feeling the warmth of the palm soothing the eyes. Feel your shoulders, head and eyes relaxing and do this for five minutes (Schneider, 2016; Peper, 2021).
- Look at the distance. Interrupt near visual stress (convergence of the eyes and tightening of the ciliary muscle around the lens allows us to focus on the screen) by looking away at the far distance. Every so look at the clouds, top of trees or rooftops outside the window to relax the eyes.
By activating the evolutionary communication patterns that allowed us to survive and thrive and using known performance enhancement skills derived from peak performance training, we can enhance involvement and productivity. The instructor needs to stay current on methods that keep students attention. At the same time, students have a responsibility to configure themselves to optimize learning. We recommend practices 1) to be present and learn, 2) optimize concentration and learning, 3) create an environment to trigger the appropriate mental and emotional state for learning, and 4) optimize arousal and regenerate vision. By taking charge of your own teaching/learning process and configuring yourself to be present through active participation, learning is enhanced.
Asurion Research (November 19, 2019). Americans Check Their Phones 96 Times a Day. https://www.asurion.com/about/press-releases/americans-check-their-phones-96-times-a-day/#:~:text=Despite%20our%20attempts%20to%20curb,tech%20care%20company%20Asurion1.
Birkett M. A. (2011). The Trier Social Stress Test protocol for inducing psychological stress. Journal of visualized experiments: JoVE, (56), 3238. https://doi.org/10.3791/3238
Chetwynd, J., Mason, L.A., Almendras, M., Peper, E., Harvey, R. (2020). Posture Awareness Training. Poster presented for the 51th Annual Scientific online Meeting of the Association for Applied Psychophysiology and Biofeedback. (Dec 2, 3, 4, 9, 10, 11, 2020). https://doi.org/10.13140/RG.2.2.20194.76485
Degges-White, S. (April 13, 2020). Dealing With Zoom Anxiety. Psychology Today. https://www.psychologytoday.com/us/blog/lifetime-connections/202004/dealing-zoom-anxiety
Flanigan, A.E. & Titsworth, S. (2020). The impact of digital distraction on lecture note taking and student learning. Instr Sci, 48, 495–524. https://doi.org/10.1007/s11251-020-09517-2
Fosslien, L. & Duffy, M. W. (2020). How to combat Zoom fatigue. Harvard Business Review. April 29, 2020. https://hbr.org/2020/04/how-to-combat-zoom-fatigue
Giunchiglia, F. Zeni, M., Gobbi, E., Bignotti,E., & Bison, I. (2018). Mobile social media usage and academic performance, Computers in Human Behavior, 82, 177-185. https://doi.org/10.1016/j.chb.2017.12.04
Gruenewald, T.L., Kemeny, M.E., Aziz, N., & Fahey. J.L. (2004). Acute threat to the social self: shame, social self-esteem, and cortisol activity. Psychosom. Med, 66, 915–924. https://doi.org/10.1097/01.psy.0000143639.61693.ef.
Intolo, P., Shalokhon, B.;, Wongwech, G., Wisiasut, P., Nathavanij, S., & Baxter, D.G. (2019). Analysis of neck and shoulder postures, and muscle activities relative to perceived pain during laptop computer use at a low-height table, sofa and bed. Work, 63(3), 361-367. https://doi.org/10.3233/WOR-192942
Jelaca, M., Anastasovski, I., & Velickovska, L.L.A. (2020). A report on the impacts of the coronovirus SARS-CO-2 “Shelter-in-place order” on fitness and well-being. Research in Physical Education, Sport and Health, 9(1), 13-18. https://doi.org/10.46733/PESH2090013j
Keller, A. S., Davidesco, I., & Tanner, K. D. (2020). Attention Matters: How Orchestrating Attention May Relate to Classroom Learning. CBE—Life Sciences Education, 19(3), fe5. https://doi.org/10.1187/cbe.20-05-0106
Kendon, A. (2004). Gesture: Visible Action as Utterance. Cambridge, England: Cambridge University Press. https://www.amazon.com/Gesture-Visible-Action-as-Utterance/dp/0521542936/ref=sr_1_2?dchild=1&keywords=Gesture%3A+Visible+Action+as+Utterance.&qid=1617248925&s=books&sr=1-2
Kuhfeld, M. Soland, J., Tarasawa, B., Johnson, Al., Ruzek, E., & Liu, J. (2020). Projecting the Potential Impact of COVID-19 School Closures on Academic Achievement. Educational Researcher, 49 (80, 549–565 https://doi.org/10.3102/0013189X20965918
Lee, J. (2020). A neuropsychological exploration of Zoom fatigue. Psychiatric Times. November 17, 2020. Accessed December 26, 2020. https://www.psychiatrictimes.com/view/psychological-exploration-zoom-fatigue
Leeb, R.T., Bitsko, R,H,, Radhakrishnan. L., Martinez, P., Njai, R., & Holland, K.M. (2020). Mental Health–Related Emergency Department Visits Among Children Aged <18 Years During the COVID-19 Pandemic — United States, January 1–October 17, 2020. MMWR Morb Mortal Wkly Rep, 69,1675– https://doi.org/10.15585 /mmwr.mm6945a3
Lemay, D.J., Doleck, T.,& Bazedlais, P. (2019). Self-determination, loneliness, fear of missing out, and academic performance. Knowledge Management & E-Learning: An International Journal, 11(4). https://doi.org/10.34105/j.kmel2019.11.025
Macan, T. H., Shahani, C., Dipboye, R. L., & Phillips, A. P. (1990). College students’ time management: Correlations with academic performance and stress. Journal of Educational Psychology, 82(4), 760–768. https://doi.org/10.1037/0022-06220.127.116.110
Madore, K.P., Khazenzon, A.M., Backes, C.W. et al. (2020).Memory failure predicted by attention lapsing and media multitasking. Nature, 587, 87–91. https://doi.org/10.1038/s41586-020-2870-z
Mărchidan, A., (2019). “More technologized is not more educated,” 2019 11th International Conference on Electronics, Computers and Artificial Intelligence (ECAI), Pitesti, Romania, 2019, pp. 1-4, https://doi.org/10.1109/ECAI46879.2019.9041993.
McGinty, E.E., Presskreischer, R., Anderson, K.E., Han, H., &Barry, C.L. (2020). Psychological distress and COVID-19–related stressors reported in a longitudinal cohort of US adults in April and July 2020. JAMA, 324(24), 2555-2557. https://doi.org/10.1001/jama.2020.21231
Mueller, P.A. & Oppenheimer, D.M. (2014). The Pen Is Mightier Than the Keyboard: Advantages of Longhand Over Laptop Note Taking. Psychological Science, 25(6) 1159–1168. https://doi.org/10.1177/0956797614524581
Newport, C. (2016). Deep Work: Rules for Focused Success in a Distracted World. New York:Grand Central Publishing. https://www.amazon.com/Deep-Work-Focused-Success-Distracted/dp/1455586692/ref=sr_1_3?dchild=1&keywords=Deep+Work%3A+Rules+for+Focused+Success+in+a+Distracted+World&qid=1617249879&s=books&sr=1-3
Osman, M.E. & Hannafin, M.J. (1994). Effects of Advance Questioning and Prior Knowledge on Science Learning, The Journal of Education Research, 88(1), 5-13. https://doi.org/10.1080/00220671.1994.9944829
Oswald, T.K., Rumbold, A.R., Kedzior, S/G.E., & Moore, V.M. (2020) Psychological impacts of “screen time” and “green time” for children and adolescents: A systematic scoping review. PLoS ONE, 15(9), e0237725. https://doi.org/10.1371/journal.pone.0237725
Patel, A.V., Maliniak, M.L., Rees-Punia, E.R., Matthews, C.E., & Gapstur, S.M. (2018). Prolonged leisure time spent sitting in relation to cause-specific mortality in a large US cohort. American Journal of Epidemiology, 187(10), 2151–2158, https://doi.org/10.1093/aje/kwy125
Peper, E. (2021). Resolve Eyestrain and Screen Fatigue. Well Being Journal, 30, 24-28. https://www.researchgate.net/publication/345123096_Resolve_Eyestrain_and_Screen_Fatigue
Peper, E. & Harvey, R. (2018). Digital addiction: increased loneliness, depression, and anxiety. NeuroRegulation. 5(1),3–8. http://dx.doi.org/10.15540/nr.5.1.3
Peper, E., Harvey, R., & Faass, N. (2020). TechStress-How Technology is Hijacking our Lives, Strategies for Coping and Pragmatic Ergonomics. Berkeley, CA: North Atlantic Books. https://www.penguinrandomhouse.com/books/232119/tech-stress-by-erik-peper-phd/
Peper, E., Harvey, R., Mason, L., & Lin, I.-M. (2018). Do better in math: How your body posture may change stereotype threat response. NeuroRegulation, 5(2), 67–74. http://dx.doi.org/10.15540/nr.5.2.67
Peper, E. & Lin, I-M. (2012). Increase or decrease depression-How body postures influence your energy level. Biofeedback, 40 (3), 126-130. https://doi.org/10.5298/1081-5937-40.3.01
Peper, E., Lin, I-M., Harvey, R., & Perez, J. (2017). How posture affects memory recall and mood. Biofeedback, 45 (2), 36-41. https://doi.org/10.5298/1081-5937-45.2.01
Peper, E. & Yang, A. (2021). Beyond Zoom Fatigue: Re-energize yourself and improve learning. Academia Letters. Adapted as a blog, Beyond zoom fatigue: Re-energize yourself and improve learning.
Porges, S.W. (2017). The pocket guide to the polyvagal theory: The transformative power of feeling safe. New York: W. W. Norton & Co. https://www.amazon.com/Pocket-Guide-Polyvagal-Theory-Transformative/dp/0393707873/ref=sr_1_2?dchild=1&keywords=The+pocket+guide+to+the+polyvagal+theory%3A+The+transformative+power+of+feeling+safe&qid=1617249068&s=books&sr=1-2
Purdy, K. (April 21, 2020). How to Pull Off a Professional Video Call From Home. New York Times Wirecutter. https://www.nytimes.com/wirecutter/blog/professional-video-call-from-home/
Roberts F., Margutti P., Takano S. (2011). Judgments concerning the valence of inter-turn silence across speakers of American English, Italian, and Japanese. Discourse Process. 48, 331–354. https://doi.org/10.1080/0163853X.2011.558002
Rubinstein, P. (2020). Asynchronous video interviews: The tools you need to succeed. 5th November 2020 https://www.bbc.com/worklife/article/20201102-asynchronous-video-interviews-the-tools-you-need-to-succeed
Schneider, M (2016). Vision for Life, Revised Edition: Ten Steps to Natural Eyesight Improvement. Berkeley, CA: North Atlantic Books. https://www.amazon.com/Vision-Life-Revised-Eyesight-Improvement/dp/1623170087/ref=sr_1_1?dchild=1&keywords=Vision+for+Life%2C+Revised+Edition%3A+Ten+Steps+to+Natural+Eyesight+Improvement&qid=1617250077&s=books&sr=1-1
Solis, B. (2019). How Managers Can Help Workers Tackle Digital Distractions. MIT Sloan Management Review, 60(4), 1-3. https://sloanreview.mit.edu/article/how-managers-can-help-workers-tackle-digital-distractions/?gclid=CjwKCAiA25v_BRBNEiwAZb4-ZRuImr0A9EtQgRLl9FXmmALLPdMAjaFDDVAJSpwo7ta8vEPLW147XRoCmO8QAvD_BwE
Stamatakis, E., Gale, J., Bauman, A., Ekelund, U., Hamer, M., & Ding, D. (2019). Sitting time, physical activity, and risk of mortality in adults. J Am Coll Cardio, 73(16), 2062-2072. https://doi.org/10.1016/j.jacc.2019.02.031
Tronick, E., Adamson, L.B., Als, H., & Brazelton, T.B. (1975, April). Infant emotions in normal and pertubated interactions. Paper presented at the biennial meeting of the Society for Research in Child Development, Denver, CO.
Tronick, E. (2007). Youtube video-Still Face Experiment: Dr. Edward Tronick. https://www.youtube.com/watch?v=apzXGEbZht0
Wilson, V.E. & Peper, E. (2011). Athletes Are Different: Factors That Differentiate Biofeedback/Neurofeedback for Sport Versus Clinical Practice. Biofeedback, 39(1), 27–30. https://doi.org/10.5298/1081-5937-39.1.01
Yalçin, I., Özkurt, B., Özmaden, M., & Yagmur, R. (2020). Effect of Smartphone Addiction on Loneliness Levels and Academic Achievement of Z Generation. International Journal of Psychology and Educational Studies, 7(1), 208-214. https://doi.org/10.17220/ijpes.2020.01.017
 We thank Professor Jackson Wilson for his incisive comments.
 In this paper will use Zoom as the example for synchronous online teaching although the concepts may apply equally to other platforms such Microsoft Teams and Google Meet.
 Zoom and other synchronous online platforms provide tools to indicate that you would like to speak (e.g., electronic hand raising); however, it is an issue of how the class session is designed (e.g., do you use breakout rooms, are there structured requests for interaction).
 Zoom has a feature to hide yourself. Start or join a Zoom meeting. The meeting automatically begins in Speaker View and you can see your own video. Then, right-click your video to display the menu, then choose Hide Myself.
Adapted from the book, TechStress: How Technology
is Hijacking our Lives, Strategies for Coping and Pragmatic Ergonomics, by Erik Peper, Richard Harvey and Nancy Faass.
Peper, E., Harvey, R., & Faass, N. (2020), TechStress-How Technology is Hijacking our Lives, Strategies for Coping and Pragmatic Ergonomics. Berkeley, CA: North Atlantic Books.
Go behind the screen and watch Inna Khazan, PhD, faculty member at Harvard Medical School and author of Biofeedback and mindfulness in everyday life: Practical solutions for improving your health and performance, interview Erik Peper, PhD and Richard Harvey, PhD. coauthors of the new book, TechStress-How Technology is Hijacking our Lives, Strategies for Coping and Pragmatic Ergonomics.
Dr. Inna Khazan interviews Dr. Erik Peper about his new book Tech Stress. We talk about some of the ways in which technology overuse affects our health and what we can do about it.
Dr. Inna Khazan interviews Dr. Rick Harvey about his new book Tech Stress, the way technology overuse can affect adults and children, and what we can do about it.
Adapted from the upcoming book, TechStress: How Technology is Hijacking Our Lives, Strategies for Coping, and Pragmatic Ergonomics, by Erik Peper, Richard Harvey and Nancy Faass.
While working in front of screens, many of us suffer from Zoom/screen fatigue, iNeck, shoulder and back discomfort, tired eyes, exhaustion and screen addiction (Peper, 2020; Fosslien & Duffy, 2020; So, Cheng & Szeto, 2017; Peper & Harvey, 2018). As we work, our shoulders and forearms tense and we are often not aware of this until someone mentions it. Many accept the discomfort and pain as the cost of doing work–not realizing that it may be possible to work without pain.
Observe how you and coworkers work at the computer, laptop or cellphone. Often we bring our noses close to the screen in order to the text more clearly and raise our shoulders when we perform data entry and use the mouse. This unaware muscle tension can be identified with physiological recording of the muscles electrical activity when they contract (electromyography) (Peper & Gibney, 2006; Peper, Harvey & Tylova, 2006). In most cases, when we rest our hands on our laps the muscle tension is low but the moment we even rest our hands on the keyboard or when we begin to type or mouse, our muscles may tighten, as shown in Figure 1. The muscle activity will also depend on the person’s stress level, ergonomic arrangement and posture.
Figure 1. Muscle tension from the shoulder and forearm increased without any awareness when the person rested their hands on the keyboard (Rest Keyboard) and during typing and mousing. The muscles only relaxed when the hands were resting on their lap (Rest Lap) (reproduced by permission from Peper, Harvey, and Faass, 2020).
Stop reading from your screen and relax your shoulders. Did you feel them slightly drop and relax?
If you experienced this release of tension and relaxation in the shoulders, then you were tightening your shoulders muscles without awareness. It is usually by the end of the day that we experience stiffness and discomfort. Do the following exercise as guided by the video or described in the text below to experience how discomfort and pain develop by maintaining low-level muscle tension.
While sitting, lift your right knee two inches up so that the foot is about two inches away from the floor. Keep holding the knee up in this position. Did you notice your breathing stopped when you lifted your knee? Are you noticing increasing tension and discomfort or even pain? How much longer can you lift the knee up?
Let go, relax and observe how the discomfort dissipates.
Reasons for the discomfort
The discomfort occurred because your muscles were contracted, which inhibited the blood and lymph flow through the tissue. When your muscles contracted to lift your knee, the blood flow in those muscles was reduced. Only when your muscles relaxed could enough blood flow occur to deliver nutrients and oxygen as well as remove the waste products of metabolism (Wan et al, 2017). From a physiological perspective, muscles work most efficiently when they alternately contract and relax. For example, most people can walk without discomfort since their muscles contract and relax with each step. However, you could hold your knee up for a few minutes before experiencing discomfort in those same muscles.
How to prevent discomfort.
To prevent discomfort and optimize health, apply the same concept of alternating tensing and relaxing to your neck, shoulder, back and arm muscles while working. Every few minutes move your arms and shoulders and let them relax. Interrupt the static sitting position with movement. If you need reminders to get up and move your body during the workday or long periods sitting in front of a device, you can download and install the free app, StretchBreak.
For more information, read and apply the concepts described in our upcoming book, TechStress: How Technology is Hijacking Our Lives, Strategies for Coping, and Pragmatic Ergonomics. The book explains why TechStress develops, why digital addiction occurs, and what you can do to prevent discomfort, improve health and enhance performance. Order the book from Amazon and receive it August 25th. Alternatively, sign up with the publisher and receive a 30% discount when the book is published August 25th. https://www.northatlanticbooks.com/shop/tech-stress/
Peper, E. & Gibney, K. H. (2006). Muscle Biofeedback at the Computer: A Manual to Prevent Repetitive Strain Injury (RSI) by Taking the Guesswork out of Assessment, Monitoring and Training. Amersfoort: The Netherlands: Biofeedback Foundation of Europe. ISBN 0-9781927-0-2. Free download of the the book: http://bfe.org/helping-clients-who-are-working-from-home/
Adapted from: Peper, E., Harvey, R. & Faass, N. (2020). TechStress: How Technology is Hijacking Our Lives, Strategies for Coping, and Pragmatic Ergonomics. Berkeley: North Atlantic Books.
Forty percent of adults and eighty percent of teenagers report experiencing significant visual symptoms (eyestrain, blurry vision, dry eyes, headaches, and exhaustion) during and immediately after viewing electronic displays. These ‘technology-associated overuse’ symptoms are often labeled as digital eyestrain or computer vision syndrome (Rosenfield, 2016; Randolph & Cohn, 2017). Even our distant vision may be affected— after working in front of a screen for hours, the world looks blurry. At the same time, we may experience an increase in neck, shoulders and back discomfort. These symptoms increase as we spend more hours looking at computer screens, laptops, tablets, e-readers, gaming consoles, and cellphones for work, taking online classes, watching streaming videos for entertainment, and keeping connected with friends and family (Borhany et al, 2018; Turgut, 2018; Jensen et al, 2002).
Eye, head, neck, shoulder and back discomfort are partly the result of sitting too long in the same position and attending to the screen without taking short physical and vision breaks, moving our bodies and looking at far objects every 20 minutes or so. The obvious question is, “Why do we stare at and are captured by, the screen?” Two answers are typical: (1) we like the content of what is on the screen; and, (2) we feel compelled to watch the rapidly changing visual scenes.
From an evolutionary perspective, our sense of vision (and hearing) evolved to identify predators who were hunting us, or to search for prey so we could have a nice meal. Attending to fast moving visual changes is linked to our survival. We are unaware that our adaptive behaviors of attending to a visual or auditory signals activate the same physiological response patterns that were once successful for humans to survive–evading predictors, identifying food, and discriminating between friend or foe. The large and small screen (and speakers) with their attention grabbing content and notifications have become an evolutionary trap that may lead to a reduction in health and fitness (Peper, Harvey & Faass, 2020).
Near vision stress
To be able to see the screen, the eyes need to converge and accommodate. To converge, the extraocular muscles of the eyes tighten; to focus (accomodation), the ciliary muscle around the lens tighten to increase the curvature of the lens. This muscle tension is held constant as long as we look at the screen. Overuse of these muscles results is near vision stress that contributes to computer vision syndrome, development of myopia in younger people, and other technology-associated overuse syndromes (Sherwin et al, 2012; Enthoven et al, 2020).
Continually overworking the visual muscles related to convergences increases tension and contributes to eyestrain. While looking at the screen, the eye muscles seldom have the chance to relax. To function effectively, muscles need to relax /regenerate after momentary tightening. For the eye muscles to relax, they need to look at the far distance– preferably objects green in color. As stated earlier, the process of distant vision occurs by relaxing the extraocular muscles to allow the eyes to diverge along with relaxing the ciliary muscle to allow the lens to flatten. In our digital age, where screen of all sizes are ubiquitous, distant vision is often limited to the nearby walls behind a screen or desk which results in keeping the focus on nearby objects and maintaining muscular tension in the eyes.
As we evolved, we continuously alternated between between looking at the far distance and nearby areas for food sources as well as signals indicating danger. If we did not look close and far, we would not know if a predator was ready to attack us. Today we tend to be captured by the screens. Arguably, all media content is designed to capture our attention such as data entry tasks required for employment, streaming videos for entertainment, reading and answering emails, playing e-games, responding to text notifications, looking at Instagram and Snapchat photos and Tiktok videos, scanning Tweets and using social media accounts such as Facebook. We are unaware of the symptoms of visual stress until we experience symptoms. To illustrate the physiological process that covertly occurs during convergence and accommodation, do the following exercise.
Sit comfortably and lift your right knee a few inches up so that the foot is an inch above the floor. Keep holding it in this position for a minute…. Now let go and relax your leg.
A minute might have seemed like a very long time and you may have started to feel some discomfort in the muscles of your hip. Most likely, you observed that when you held your knee up, you most likely held your breath and tightened your neck and back. Moreover, to do this for more than a few minutes would be very challenging.
Lift your knee up again and notice the automatic patterns that are happening in your body.
For muscles to regenerate they need momentary relaxation which allows blood flow and lymph flow to occur. By alternately tensing and relaxing muscles, they can work more easily for longer periods of time without experiencing fatigue and discomfort (e.g., we can hike for hours but can only lift our knee for a few minutes).
Solutions to relax the eyes and reduce eye strain
- Reestablish the healthy evolutionary pattern of alternately looking at far and near distances to reduce eyestrain, such as:
- Look out through a window at a distant tree for a moment after reading an email or clicking link.
- Look up and at the far distance each time you have finished reading a page or turn the page over.
- Rest and regenerate your eyes with palming. While sitting upright, place a pillow or other supports under our elbows so that your hands can cover your closed eyes without tensing the neck and shoulders.
- Cup the hands so that there is no pressure on your eyeballs, allow the base of the hands to touch the cheeks while the fingers are interlaced and resting your forehead.
- Close your eyes, imagine seeing black. Breathe slowly and diaphragmatically while feeling the warmth of the palm soothing the eyes. Feel your shoulders, head and eyes relaxing. Palm for 5 minutes while breathing at about six breaths per minute through your nose. Then stretch and go back to work.
Palming is one of the many practices that improves vision. For a comprehensive perspective and pragmatic exercises to reduce eye strain, maintain and improve vision, see the superb book by Meir Schneider, PhD., L.M.T., Vision for Life, Revised Edition: Ten Steps to Natural Eyesight Improvement.
Increased sympathetic arousal
Seeing the changing stimuli on the screen evokes visual attention and increases sympathetic arousal. In addition, many people automatically hold their breath when they see novel visual or hear auditory signals; since, they trigger a defense or orienting response. At the same time, without awareness, we may tighten our neck and shoulder muscles as we bring our nose literally to the screen. As we attend and concentrate to see what is on the screen, our blinking rate decreases significantly. From an evolutionary perspective, an unexpected movement in the periphery could be a snake, a predator, a friend or foe and the body responds by getting ready: freeze, fight or flight. We still react the same survival responses. Some of the physiological reactions that occur include:
- Breath holding or shallow breathing. These often occur the moment we receive a text notification, begin concentrating and respond to the messages, or start typing or mousing. Without awareness, we activate the freeze, flight and fight response. By breath holding or shallow breathing, we reduce or limit our body movements, effectively becoming a non-moving object that is more difficult to see by many animal predators. In addition, during breath holding, hearing become more acute because breathing noises are effectively reduced or eliminated.
- Inhibition of blinking. When we blink it is another movement signal that in earlier times could give away our position. In addition, the moment we blink we become temporarily blind and cannot see what the predator could be doing next.
- Increased neck, shoulder and back tension. The body is getting ready for a defensive fight or avoidance flight.
Experience some of these automatic physiological responses described above by doing the following two exercises.
Eye movement neck connection: While sitting up and looking at the screen, place your fingers on the back of the neck on either side of the cervical spine just below the junction where the spine meets the skull.
Feel the muscles of neck along the spine where they are attaching to the skull. Now quickly look to the extreme right and then to the extreme left with your eyes. Repeat looking back and forth with the eyes two or three times.
What did you observe? Most likely, when you looked to the extreme right, you could feel the right neck muscles slightly tightening and when you looked the extreme left, the left neck muscles slightly tightening. In addition, you may have held your breath when you looked back and forth.
Focus and neck connection: While sitting up and looking at the screen, place your fingers on the back of the neck as you did before. Now focus intently on the smallest size print or graphic details on the screen. Really focus and concentrate on it and look at all the details.
What did you observe? Most likely, when you focused on the text, you brought your head slightly forward and closer to the screen, felt your neck muscles tighten, and possibly held your breath or started to breathe shallowly.
As you concentrated, the automatic increase in arousal, along with the neck and shoulder tension and reduced blinking contributes to developing discomfort. This can become more pronounced after looking at screens to detailed figures, numerical data, characters and small images for hours (Peper, Harvey & Tylova, 2006; Peper & Harvey, 2008; Waderich et al, 2013).
Staying alert, scanning and reacting to the images on a computer screen or notifications from text messages, can become exhausting. in the past, we scanned the landscape, looking for information that will help us survive (predators, food sources, friend or foe) however today, we react to the changing visual stimuli on the screen. The computer display and notifications have become evolutionary traps since they evoke these previously adaptive response patterns that allowed us to survive.
The response patterns occur mostly without awareness until we experience discomfort. Fortunately, we can become aware of our body’s reactions with physiological monitoring which makes the invisible visible as shown in the figure below (Peper, Harvey & Faass, 2020).
Representative physiological patterns that occur when working at a computer, laptop, tablet or cellphone are unnecessary neck and shoulder tension, shallow rapid breathing, and an increase in heart rate during data entry. Even when the person is resting their hands on the keyboard, forearm muscle tension, breathing and heart rate increased.
Moreover, muscle tension in the neck and shoulder region also increased, even when those muscles were not needed for data entry task. Unfortunately, this unnecessary tension and shallow breathing contributes to exhaustion and discomfort (Peper, Harvey & Faass, 2020).
With biofeedback training, the person can learn to become aware and control these dysfunctional patterns and prevent discomfort (Peper & Gibney, 2006; Peper et, 2003). However, without access to biofeedback monitoring, assume that you respond similarly while working. Thus, to prevent discomfort and improve health and performance, implement the following.
- Practice breathing lower and slower to reduce sympathetic activation. Every few minutes remember to breathe slowly in and out through the nose. See the following blogs for more detailed instructions:
- Blink many times. Blink each time you click on a link, after typing a paragraph or after entering a few numbers.
- Get up, move, stretch and wiggle.
- Every few minutes do a small movement such as rotating your shoulders, dropping your hands to your lap.
- Every twenty minutes get up, stretch and walk around to reduce the chronic muscle tension.
- Install the free Stretch Break software on your computer or laptop to remind you to stretch… and then shows you how. Download free version from: https://stretchbreak.com/.
- Use small portable muscle biofeedback devices to learn awareness of the covert muscle tension and how to work without unnecessary muscle tension. For detailed training procedures see the free downloadable book by Erik Peper and Katherine Gibney, Muscle Biofeedback at the Computer- A Manual to Prevent Repetitive Strain Injury (RSI) by Taking the Guesswork out of Assessment, Monitoring and Training.
Finally, for a comprehensive overview based on an evolutionary perspective that explains why TechStress develops, why digital addiction occurs. and what can be done to prevent discomfort and improve health and performance, see our new book by Erik Peper, Richard Harvey and Nancy Faass, Tech Stress-How Technology is Hijack our Lives, Strategies for Coping and Pragmatic Ergonomics.
Enthoven, C. A., Tideman, W.L., Roel of Polling, R.J.,Yang-Huang, J., Raat, H., & Klaver, C.C.W. (2020). The impact of computer use on myopia development in childhood: The Generation R study. Preventtive Medicine, 132, 105988.
Peper, E. & Gibney, K. (2006). Muscle Biofeedback at the Computer- A Manual to Prevent Repetitive Strain Injury (RSI) by Taking the Guesswork out of Assessment, Monitoring and Training. The Biofeedback Federation of Europe. Download free PDF version of the book: http://bfe.org/helping-clients-who-are-working-from-home/
Peper, E., Wilson, V.S., Gibney, K.H., Huber, K., Harvey, R. & Shumay. (2003). The Integration of Electromyography (sEMG) at the Workstation: Assessment, Treatment and Prevention of Repetitive Strain Injury (RSI). Applied Psychophysiology and Biofeedback, 28 (2), 167-182.
Sherwin, J.C., Reacher, M.H., Keogh, R. H., Khawaja, A. P., Mackey, D.A.,& Foster, P. J. (2012). The association between time spent outdoors and myopia in children and adolescents. Ophthalmology,119(10), 2141-2151.
Waderich, K., Peper, E., Harvey, R., & Sara Sutter. (2013). The psychophysiology of contemporary information technologies-Tablets and smart phones can be a pain in the neck. Presented at the 44st Annual Meeting of the Association for Applied Psychophysiology and Biofeedback. Portland, OR.
Numerous people report that working at the computer at home is more tiring than working in the office. Although there are obvious advantages to working at home, there are also disadvantages (e.g., no space to work, challenging ergonomics, no escape from the family, lack of nonverbal cues used to communicate, less informal sharing at the water cooler, increased multitasking by working and having to take care of the children).
A major challenge is having a comfortable work space in your home. This may mean finding a place to put the computer, keyboard and screen. For some it is the kitchen table, desk in the corner of the bedroom, or coffee table while other it is in a totally separate room.
Incorrect ergonomic arrangement and stressed work style often increases neck, shoulder discomfort and aggravates eye strain and tiredness. Regardless how your digital work space is organized, implement the following life and work style suggestions and ergonomics recommendations to promote health.
LIFE AND WORK STYLE SUGGESTIONS
Take many, many, many breaks. Movement breaks will reduce the covert static tension that builds up as we sit in static positions and work at the computer.
- Every few minutes take a small break such as stand up and wiggle or role your shoulders. When performing the movements, stop looking at the screen and look around the room or out the window.
- Every 30 minutes get up walk around for and move your body. Use timers to notify you every 30 minutes to take a break (e.g., cellphone alarms or personal digital assistants such as Hey Google, Siri, or Alexa).
- Take vision breaks to reduce eye fatigue.
- Every few minutes look away from the screen and into the far distance and blink. If at all possible look outside at green plants which relaxes the near vision induced tension.
- Blink and blink again. When working at the computer we reduce our blinking rate. Thus, blink each time you click on a new link, finishing entering a column of numbers, etc.
- Close your eyes by letting the eye lids drop down as you also relax your jaw. Imagine a hook on top of your head which is pulling your head upward and at the same time drop your shoulders.
- Reduce glare and bright backgrounds
- Arrange your computer screen at 90 degrees to the brightest light source.
- Have a darker background behind you when participating in video conferencing (e.g., Zoom, Skype, GoToMeeting, WhatsApp, FaceTime). Your face will be visible.
- When stressed remember to breathe. As you inhale let your stomach expand as you exhale let the air flow out slowly.
- Stop watching and listening to the negative news (check the news no more than once a day). Watch positive and humorous movies.
- Get fresh air, go for a walk, and be in the sun
- Reconnect with friends and share positive experiences.
- Remind yourself, that this too shall pass.
ERGONOMIC RECOMMENDATIONS: MAKE THE WORLD YOURS
Good ergonomics means adapting the equipment and environment to you and not the other way around. Optimizes the arrangement of the chair, desk, keyboard, mouse, camera, screen and yourself as shown in Figure 1.
Figure 1. Recommended arrangement for working at the computer.
Arrange the laptop
The laptop is challenging because if your hands are at the right height for data entry on the keyboard, then you must look down to see the screen. If the screen at the right height, then you have to raise your hands to reach the keyboard. There are two solutions for this challenge.
- Use an external keyboard and mouse, then raise the laptop so that the top of the screen is at eye level. Use a laptop stand or a stack of books to raise the lap top.
- Use an external monitor for display, then use the laptop as your keyboard.
If these solutions are not possible, take many, many, many breaks to reduce the neck and shoulder stress.
Arrange the computer workstation
- Adjust the chair so that your forearms can rest on the table without raising your shoulders. This may mean sitting on a pillow. If the chair is then too high and your legs dangle, create a foot stool on which you can rest your feet.
- Adjust the monitor so that the top of the screen is at eye level. If the monitor is too low, raise it by putting some books underneath it.
- If possible, alternate standing and sitting while working.
Tech Stress: How Technology Is Hijacking Our Lives, Strategies for Coping, and Pragmatic Ergonomics provides insight in how discomfort, symptoms and media addiction develops and what you can do about it. It incorporates the role of evolutionary traps, how biofeedback makes the unaware aware, experiential physical and cognitive practices, and ergonomic recommendations to optimize health and productivity. A must book for anyone using digital devices. Peper, E., Harvey, R., & Faass, (2020). Tech Stress: How Technology Is Hijacking Our Lives, Strategies for Coping, and Pragmatic Ergonomics. Berkeley: North Atlantic Books.
Ergonomic suggestions for working at the computer and laptop.
11 tips for working at home
How our digital world activates evolutionary response patterns.
How posture affects health